Objective:Adequate knowledge of parents’ perception of quality of pediatric cancer care helps to identify the areas of care improvement which would contribute to disease outcome in regard to the quality of life and satisfaction with the care provided. The aim of the study was to assess the parents’ perception of the quality of Pediatric Oncology Inpatient Care at Kenyatta National Hospital.Methods:A cross-sectional descriptive quantitative and qualitative study was undertaken using a pretested semi-structured questionnaire and a focused group discussion guide. Assessment of parents’ perception of quality of care was done in relation to the institution's structures and care delivery processes. These included the ward environment, resources for cancer treatment, care processes, service providers, and parents’ knowledge empowerment. Participants were systematically selected. Parents’ perception was defined as satisfaction or dissatisfaction with the care provided. Data were analyzed using SPSS version 20.0 (Armonk, NY: IBM Corp.) and presented as frequencies and percentages. Chi-square was used to test the significant association between variables. Level of significance was set at a P ≤ 0.05.Results:A total of 107 respondents were interviewed and 57.9% were satisfied with the overall quality of care they received. The determinants of overall satisfaction in this study were found to be related to resources for cancer treatment (odds ratio [OR] =3.10; 95% confidence interval [CI] =1.39–6.90; P = 0.005), care delivery processes (OR = 2.87; 95% CI = 1.28–6.43; P = 0.009), and the ward environment (OR = 2.59; 95% CI = 1.17–5.74; P = 0.018).Conclusions:The parents were moderately satisfied with the oncology care services their children received. The gaps identified in service delivery included those related to the availability of the required resources for efficient care delivery and also educational as well as psychosocial needs of the parents.

Research-based practice in nursing and midwifery is regarded as a means of ensuring that quality care is provided by integrating individual clinical expertise with the best available clinical evidence from systematic research. Previous studies indicate that few midwives strive to achieve their role of safe motherhood by helping women and their families through the pregnancy and childbirth process using research-based practice. The study documents the practice of episiotomy by midwives in an urban setting. This is a cross-sectional qualitative and quantitative descriptive study. All midwives working in the labour ward at Pumwani Maternity Hospital in June–July 2009 were eligible for the study. A standard questionnaire was used to collect data regarding socio-demographic characteristics, professional training and evidence-based knowledge. Consenting and qualifying midwives were eligible for study. In-depth interviews were conducted among key informants over the same period. Data were analyzed using Statistical Package for the Social Sciences (SPSS). The most common types of episiotomy preferred by the midwives was medio-lateral and midline. Various factors were reported to have influenced the midwives practices: very tight perineum, breech presentation, premature labour, female genital mutilation, instrumental delivery and status of the fetus. In-depth interviews demonstrated lack of specific guidelines on specific procedures, personal attitudes and inadequate administration support. The study recommends an urgent need to put in place modalities to ensure that guidelines are developed and used appropriately in order to standardize provision of services.

Aims: A survey carried out in the maternity centre of a Kenyan county hospital sought to evaluate the institutional factors influencing women's perception of quality of intrapartum care. Methods: This cross-sectional quantitative and qualitative study involved 195 postpartum mothers, who were randomly sampled. A questionnaire, a focus group discussion and a key informant interview were used to collect data. Findings: The study indicated that there was a positive relationship between women's perceptions of quality of intrapartum care and institutional factors, such as cost of services and comfort in waiting rooms (P = 0.007 and 0.025, respectively). Residing near a hospital was also associated with a positive perception of the quality of intrapartum care. Conclusions: This study reveals that it is important to provide an affordable and accessible environment during childbirth to improve the women's perception of quality of care provided during this period. This study's findings have implications in the design of maternity centres and the implementation of free maternity services in Kenya.

Background/Aims: Cancer and its treatment affects the quality of life in patients. In Africa, there is limited research available on the quality of life among cancer patients. This study describes quality of life in patients with gynaecological cancer attending Kenyatta National Hospital, Kenya. Methods: A descriptive study was conducted among patients with gynaecological cancer attending the palliative care unit. Data were collected using a structured questionnaire adopting the Missoula-VITAS Quality of Life Index, a 25-item quality of life measure containing five subscales. Results: A total of 108 patients were interviewed. The mean total quality of life score was 17.2 (possible range 0 to 30), and the mean global quality of life score was 3.5 (possible range 0 to 5). The following subscale mean scores were recorded: symptom (8.2), transcendent (6.2), function (5.6), interpersonal (5.3) and wellbeing (–2.9) (possible range –30 to 30). Conclusions: The quality of life of patients with gynaecological cancer was moderate, while insufficient attention to patients' psychosocial needs adversely affected patients' perceptions of their quality of life.

Background: Maternal health is one of the eight Millennium Development Goals,is central to poverty reduction and overall development efforts and it increased international attention for monitoring progress on maternal health and improving access to skilled attendants at deliveries. This research paper aimed to study economic and education determinants on the utilization of skilled delivery services by Maasai women, the study population belonging to a community of nomadic life style in North of Kajiado County in Kenya.Methods: The study design was a cross sectional descriptive study adopting both quantitative and qualitative methodologies. Results: Utilization of skilled delivery was higher among women who had a source of income (34%) compared to women who had no source of income (19%) indicating a statistical significance p=0.003. Women who had higher level of education were more likely to use skilled delivery 50% compared to 22% who had no education at all hence p=0.002. Education level had a statistical significance, (p-0.002). 69% of those who delivered in the hospital paid > 500 shillings compared to 8% of those who paid < 500 shillings. The amount paid for skilled delivery had a statistical significance, (p<0.001). 97.7% of the Maasai women in the Kajiado North study takes more than 1hour to reach to the nearest health facility while less than (1%) of them in this study takes less than 30minutes to reach to the health facility. Conclusions: In conclusion this study shows that high level of illiteracy, low economic status, distance away, cost to pay for skilled delivery hindered skilled delivery service utilization among the Maasai women.